The mineralocorticoid receptor in skin disease.

The Mineralocorticoid Receptor (MR or NR3C2) is expressed in all cell types of the different skin compartments and can be bound and activated by glucocorticoids (GCs) with higher affinity than its closely related glucocorticoid (GC) receptor (GR or NR3C1). As both corticosteroid receptors co-express in skin, and considering the therapeutic relevance of GCs to combat skin inflammatory diseases, it was proposed that several of the major side-effects of topical GCs such as skin atrophy and delayed wound healing were due to unintended activation of the MR. Indeed, cutaneous MR blockade using genetic and pharmacological approaches in mice and human reduced the GC-associated skin atrophy in conditions of endogenous and pharmacological GC excess. While data support the safety of topical MR antagonists combined with GCs, it is crucial to address the efficacy of treatment in skin inflammatory conditions and its impact on the overall metabolism.